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City of Prior Lake
Sump Pump and I/I Reduction
ection Form ~. a P-~.
Name: ~ah~eri 1~a~1 ~ ~~,f~y
Address: /GQ~ ~ /~vr-f'~~,,.oa~ ~PD ~ltv~/
Prior Lake, MN 55 ; 7,~ Phone: ~J ~ 7- ~~'
Date: T Z/- 9 9 Time: / y> o a.m./p.m.
First Inspection L~ Second ~
Own: 13"" Rent: ~ Age of Home: ~ f 2~ 7
Residential: L~ ~~~,• ~~.oHs
Non-Residential: ~
A. BASEMENT Q Yes /F ~C~'No "~~ SIJMP BASKET ~ 0 ~ 1 ~ 2 ~ 3 ~
WATER IN BASKET O Yes ~ No SUMP PUMP ~~ 1 ~ 2 Q 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes C-#~T"o CI5TERN O Yes J~-#b"
(If no pump, place sticker across edge of sump cover and basement floor so any removal of cover will
break seal. Skip to Part B of this form. )
Discharge Point ~ Laundry tub Q Sanitary sewer ~ Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date)
O Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Previous system failed
and why
B. ROOF LEADERS: ~1"'I'es ~ No DISCHARGE: Q Near ~''~way
C. YARD DRAINS ~ Yes l~''No WINDOW WELLS ~ Yes L~To
BEAVER SYSTEM ~ Yes I~'l~o
D. PROPERTIES WITH SUMP PUMPS
When does pump run? Ca Fall O Summer Q Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? Q Front O Back 17 Side
NOTES:
SUMP PUMP SYSTEM: C~''~ASS 17 FAIL You have 30 days to bring your system into compliance with current
reguladons. When you are ready for reinspection, cal[ 6511644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~- ~o
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: z ~ Date: ,s= Z/- 9 9
Resident: Date: ~'- ~ /- 99
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imply the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HR~